Insulinoma other diagnostic studies: Difference between revisions
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==Other Diagnostic Studies== | ==Other Diagnostic Studies== | ||
===Arterial calcium Stimulation with Hepatic Venous Sampling=== | |||
*Arterial calcium Stimulation with Hepatic Venous Sampling(ASVS) may be helpful in the diagnosis of insulinoma when all other non invasive methods and even invasive test ike Endoscopic ultrasound have failed to localize the tumor. ASVS is also the diagnostic test of choice for endogenous hyperinsulinism. It provides a more accurate localization and reduces the risk of repeating surgeries. It has a greater sensitivity of 100% but specificity of 20-50%.<ref name="pmid27795707">{{cite journal |vauthors=Moreno-Moreno P, Alhambra-Expósito MR, Herrera-Martínez AD, Palomares-Ortega R, Zurera-Tendero L, Espejo Herrero JJ, Gálvez-Moreno MA |title=Arterial Calcium Stimulation with Hepatic Venous Sampling in the Localization Diagnosis of Endogenous Hyperinsulinism |journal=Int J Endocrinol |volume=2016 |issue= |pages=4581094 |year=2016 |pmid=27795707 |pmc=5066019 |doi=10.1155/2016/4581094 |url=}}</ref><ref name="pmid16360384">{{cite journal |vauthors=Grover AC, Skarulis M, Alexander HR, Pingpank JF, Javor ED, Chang R, Shawker T, Gorden P, Cochran C, Libutti SK |title=A prospective evaluation of laparoscopic exploration with intraoperative ultrasound as a technique for localizing sporadic insulinomas |journal=Surgery |volume=138 |issue=6 |pages=1003–8; discussion 1008 |year=2005 |pmid=16360384 |doi=10.1016/j.surg.2005.09.017 |url=}}</ref><ref name="pmid9426437">{{cite journal |vauthors=Brown CK, Bartlett DL, Doppman JL, Gorden P, Libutti SK, Fraker DL, Shawker TH, Skarulis MC, Alexander HR |title=Intraarterial calcium stimulation and intraoperative ultrasonography in the localization and resection of insulinomas |journal=Surgery |volume=122 |issue=6 |pages=1189–93; discussion 1193–4 |year=1997 |pmid=9426437 |doi= |url=}}</ref> <ref name="pmid17431724">{{cite journal |vauthors=Tseng LM, Chen JY, Won JG, Tseng HS, Yang AH, Wang SE, Lee CH |title=The role of intra-arterial calcium stimulation test with hepatic venous sampling (IACS) in the management of occult insulinomas |journal=Ann. Surg. Oncol. |volume=14 |issue=7 |pages=2121–7 |year=2007 |pmid=17431724 |doi=10.1245/s10434-007-9398-4 |url=}}</ref><ref name="pmid10741793">{{cite journal |vauthors=Baba Y, Miyazono N, Nakajo M, Kanetsuki I, Nishi H, Inoue H |title=Localization of insulinomas. Comparison of conventional arterial stimulation with venous sampling (ASVS) and superselective ASVS |journal=Acta Radiol |volume=41 |issue=2 |pages=172–7 |year=2000 |pmid=10741793 |doi= |url=}}</ref> | *Arterial calcium Stimulation with Hepatic Venous Sampling(ASVS) may be helpful in the diagnosis of insulinoma when all other non invasive methods and even invasive test ike Endoscopic ultrasound have failed to localize the tumor. ASVS is also the diagnostic test of choice for endogenous hyperinsulinism. It provides a more accurate localization and reduces the risk of repeating surgeries. It has a greater sensitivity of 100% but specificity of 20-50%.<ref name="pmid27795707">{{cite journal |vauthors=Moreno-Moreno P, Alhambra-Expósito MR, Herrera-Martínez AD, Palomares-Ortega R, Zurera-Tendero L, Espejo Herrero JJ, Gálvez-Moreno MA |title=Arterial Calcium Stimulation with Hepatic Venous Sampling in the Localization Diagnosis of Endogenous Hyperinsulinism |journal=Int J Endocrinol |volume=2016 |issue= |pages=4581094 |year=2016 |pmid=27795707 |pmc=5066019 |doi=10.1155/2016/4581094 |url=}}</ref><ref name="pmid16360384">{{cite journal |vauthors=Grover AC, Skarulis M, Alexander HR, Pingpank JF, Javor ED, Chang R, Shawker T, Gorden P, Cochran C, Libutti SK |title=A prospective evaluation of laparoscopic exploration with intraoperative ultrasound as a technique for localizing sporadic insulinomas |journal=Surgery |volume=138 |issue=6 |pages=1003–8; discussion 1008 |year=2005 |pmid=16360384 |doi=10.1016/j.surg.2005.09.017 |url=}}</ref><ref name="pmid9426437">{{cite journal |vauthors=Brown CK, Bartlett DL, Doppman JL, Gorden P, Libutti SK, Fraker DL, Shawker TH, Skarulis MC, Alexander HR |title=Intraarterial calcium stimulation and intraoperative ultrasonography in the localization and resection of insulinomas |journal=Surgery |volume=122 |issue=6 |pages=1189–93; discussion 1193–4 |year=1997 |pmid=9426437 |doi= |url=}}</ref> <ref name="pmid17431724">{{cite journal |vauthors=Tseng LM, Chen JY, Won JG, Tseng HS, Yang AH, Wang SE, Lee CH |title=The role of intra-arterial calcium stimulation test with hepatic venous sampling (IACS) in the management of occult insulinomas |journal=Ann. Surg. Oncol. |volume=14 |issue=7 |pages=2121–7 |year=2007 |pmid=17431724 |doi=10.1245/s10434-007-9398-4 |url=}}</ref><ref name="pmid10741793">{{cite journal |vauthors=Baba Y, Miyazono N, Nakajo M, Kanetsuki I, Nishi H, Inoue H |title=Localization of insulinomas. Comparison of conventional arterial stimulation with venous sampling (ASVS) and superselective ASVS |journal=Acta Radiol |volume=41 |issue=2 |pages=172–7 |year=2000 |pmid=10741793 |doi= |url=}}</ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]
Overview
[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].
Other Diagnostic Studies
Arterial calcium Stimulation with Hepatic Venous Sampling
- Arterial calcium Stimulation with Hepatic Venous Sampling(ASVS) may be helpful in the diagnosis of insulinoma when all other non invasive methods and even invasive test ike Endoscopic ultrasound have failed to localize the tumor. ASVS is also the diagnostic test of choice for endogenous hyperinsulinism. It provides a more accurate localization and reduces the risk of repeating surgeries. It has a greater sensitivity of 100% but specificity of 20-50%.[1][2][3] [4][5]
Basis of ASVS
A hyperosmolar concentration of calcium in the vessels supplying the tumor will cause degranulation of cells within the neoplasm, releasing insulin into the portal venous system, which results in a detectable rise in insulin levels in venous samples obtained from the hepatic vein
Findings diagnostic of insulinoma include:
- visulized under early arterial phase
- well-defined, round or oval blushes of hypervascularity as compared to parenchyma of pancreas.
References
- ↑ Moreno-Moreno P, Alhambra-Expósito MR, Herrera-Martínez AD, Palomares-Ortega R, Zurera-Tendero L, Espejo Herrero JJ, Gálvez-Moreno MA (2016). "Arterial Calcium Stimulation with Hepatic Venous Sampling in the Localization Diagnosis of Endogenous Hyperinsulinism". Int J Endocrinol. 2016: 4581094. doi:10.1155/2016/4581094. PMC 5066019. PMID 27795707.
- ↑ Grover AC, Skarulis M, Alexander HR, Pingpank JF, Javor ED, Chang R, Shawker T, Gorden P, Cochran C, Libutti SK (2005). "A prospective evaluation of laparoscopic exploration with intraoperative ultrasound as a technique for localizing sporadic insulinomas". Surgery. 138 (6): 1003–8, discussion 1008. doi:10.1016/j.surg.2005.09.017. PMID 16360384.
- ↑ Brown CK, Bartlett DL, Doppman JL, Gorden P, Libutti SK, Fraker DL, Shawker TH, Skarulis MC, Alexander HR (1997). "Intraarterial calcium stimulation and intraoperative ultrasonography in the localization and resection of insulinomas". Surgery. 122 (6): 1189–93, discussion 1193–4. PMID 9426437.
- ↑ Tseng LM, Chen JY, Won JG, Tseng HS, Yang AH, Wang SE, Lee CH (2007). "The role of intra-arterial calcium stimulation test with hepatic venous sampling (IACS) in the management of occult insulinomas". Ann. Surg. Oncol. 14 (7): 2121–7. doi:10.1245/s10434-007-9398-4. PMID 17431724.
- ↑ Baba Y, Miyazono N, Nakajo M, Kanetsuki I, Nishi H, Inoue H (2000). "Localization of insulinomas. Comparison of conventional arterial stimulation with venous sampling (ASVS) and superselective ASVS". Acta Radiol. 41 (2): 172–7. PMID 10741793.